Elevated Pulmonary Artery Pressure: Discussion (Part 5)
A recent clinical trial among mildly hypertensive patients demonstrated that despite regression of LV mass with blood pressure control, diastolic filling rates did not return to normal. These findings suggest that the diastolic abnormalities of hypertensive heart disease may persist after reduction in protein mass. Similar loss of compliance may have occurred among the third of patients who had experienced a prior myocardial infarction. However, since the relative risk associated with high pulmonary pressures was virtually identical in patients with 0-, 1-, 2-, and 3-vessel coronary disease, we assume that whatever the cause for the loss of compliance, the pathophysiologic outcome remained the same. buy yasmin online
An additional potential explanation of the significance of an increased PAMP may be its role as a marker for the effect of hypertension on the pulmonary vascular bed. It is well known, for example, that there is marked variability in pulmonary vascular reactivity to various stimuli, including hypoxia and chronic increases in pulmonary venous pressure. The elevation of PAMP may reflect changes in the pulmonary circulation related to hormonal or other systemic abnormalities associated with essential hypertension that contribute to an increased risk of cardiac death.